Heavy drinking may be an unfortunate consequence of progress for women

Do you drink to that … and that … and that?

Haley Bakker, 25, doesn’t have a drinking problem. Sure, the public relations associate regularly hits the Chicago bar scene with friends and frequently sips cocktails at business events. And sure, the drink she often holds in one hand feels as natural as the smartphone in the other. But like most of her pals, Haley rarely gets drunk, almost never wakes up with a hangover, and always takes a cab home.

When asked how many drinks she has in a typical week, Haley’s first guess is five or six. Then she does the math: Monday night might find her catching up with a girlfriend over cocktails. Tuesday, it’s dinner with her boyfriend and a bottle of red. Wednesday, a going-away party for a coworker and vodka tonics all around. Thursday is movie night at home with takeout and white wine. Friday is the office cocktail hour where everyone gathers to toast landing a new account. Saturday is a night out at the bars, followed by Sunday brunch with Bloody Marys. Her initial estimate was way off, by at least half, she admits. It’s easy to lose track.

Very easy, especially in a post-Sex and the City culture in which socializing is often synonymous with clinking glasses, and an after-work nip with clients isn’t only normal, it’s practically de rigueur. Per a July 2012 Gallup poll, 44 percent of Americans drink alcohol regularly, and 22 percent admit they sometimes imbibe more than they should, despite U.S. dietary health guidelines that state women should sip no more than seven drinks a week and no more than three on any given day.

“As a society, we have long blown past those guidelines,” says clinical psychologist Joseph Nowinski, Ph.D., author of Almost Alcoholic. And while a seven-drink weekly limit might seem a little strict to some, a slew of research has found that regularly exceeding it over time can lead to both health hiccups (low energy, blotchy skin) and health disasters (certain cancers, strokes). To wit, in September, the U.S. Preventive Services Task Force was compelled to draft a recommendation to primary-care physicians: Talk to your patients about risky drinking behaviors, stat. Those M.D.s are in for a challenge. (Do you want to drink less? Learn What Kicking Cocktails for a Month Will Do for Your Health.)

In the past, people who got sauced in college typically “aged out” of frequent drinking when they started working, got married, or had kids, says Ohio University sociologist Thomas Vander Ven, Ph.D., who studies alcohol use in modern culture. Now, as women delay marriage and motherhood, they may hang on to their habits and come up against new kinds of pressures to imbibe.

Indulging in designer wines or haute cocktails now implies a cool, coveted sophistication, a new measure of social achievement. Drinking the right beverage can be an accessory to hipness–it can also be a key to getting ahead at the office.

“It may be an unfortunate consequence of progress for women,” says Vander Ven. “Those who’ve finally found equality on the job might now feel compelled to find it at the bar.” Indeed, in Haley’s experience, not drinking can raise some judgmental or disapproving eyebrows in both her social and professional circles.

Dana Humphrey, a 29-year-old New Yorker who owns her own marketing firm, agrees. After she recently scored a contract, two of her new clients broke out a bottle of tequila. In the space of a few minutes, she’d downed three shots (the first to seal the deal; the second and third, congratulatory toasts from each man). “I felt like they were expecting me to match them drink for drink,” says Dana. “It’s like an earning-respect thing. They want you to keep up, but they want you to be able to handle it.” Men still look down on a woman who gets sloppy drunk, she says. Yet a normal night for her could include two or three networking events, at which, she says, “there is definite pressure to have a glass of wine in your hand.”

It’s not all peer influence, of course. Knocking back a few after a frantic day can feel like a blissful escape. (Google, possibly cognizant of the fact that a young, talented workforce uses booze as both a professional lubricant and a fun way to blow off steam, reportedly offers employees free beer.) And most women who swallow more than seven drinks a week aren’t in alcoholic territory, admits Nowinski. But they aren’t totally safe either. Thanks to growing drink sizes and a near-total lack of awareness about what booze does to the human body, many women may be inadvertently setting themselves up for future health hazards. (Goblet-sized wine glasses are growing in popularity. Why Drinks Are Getting Bigger–and Stronger.)

A woman may drink like one of the boys, but she can’t handle her liquor in the same way. Booze wreaks more and faster havoc on the female body, says Sam Zakhari, Ph.D., a former director at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). As alcohol works its way through the digestive tract, it gets diluted before coursing through the bloodstream. In general, women have much less water in their bodies than men do (and less of an enzyme that breaks down booze), meaning that after a drink, their organs are exposed to higher levels of alcohol for longer periods of time. (Are you dehydrated? Find out How Much Water You Should Drink.)

Moderate drinking, or staying within the government’s guidelines, is unlikely to cause any major organ damage or serious health issues, says Zakhari. Nor is the rare wild night out. But women who regularly drink heavily–defined by the Centers for Disease Control and Prevention as swallowing an average of more than one drink per day–should watch out for the following: Alcohol can disrupt communication between the brain’s neurotransmitters, which help control everything from thinking to breathing to movement. As such, long-term overdrinking can trigger depression, anxiety, and memory misfires. It can also shrink brain cells.Over time, excess booze weakens heart muscles, preventing them from pumping out sufficient blood. What’s more, women who binge drink (that’s four or more drinks in two hours) have a roughly 39 percent higher risk for stroke.It’s no surprise that the liver takes a hit. The organ breaks down alcohol, a process that produces toxins that promote inflammation and weaken the body’s natural defenses.The reason all serial heavy drinkers aren’t fat: Alcohol can throw off metabolism, eventually knocking the body into weight loss. But before you drink to diet, know this: Alcohol can interfere with protein formation, thereby reducing muscle mass and weakening your overall health, says Zakhari. (There are plenty of healthier calorie-burning habits you can adopt, like these 15 Ways to Rev Your Metabolism.)That ruddy look you get after a few sips? Alcohol dilates peripheral blood vessels, causing a rush of blood to the skin, especially in the face. Excessive drinking can also deplete the body of skin-improving vitamin A.Long-term imbibing can curb your white blood cells’ ability to fight off harmful bacteria. That means a weaker immune system and a faulty defense against things like STDs or even the common cold. Possibly related: Heavy drinking also increases your risk for many cancers, including breast cancer, according to the American Cancer Society.

All that said, there isn’t always a straight line between overindulging and, say, heart disease or cancer. And research does suggest booze in moderation may have some upsides. “There are benefits, for example, to drinking just five ounces of red wine per day,” says Elizabeth J. Kovacs, Ph.D., director of the Alcohol Research Program at Loyola University Medical Center.

The problem is that many women hear “drinking is healthy!” and then go overboard, or they consider themselves normal social drinkers without realizing they’re sipping over the recommended limit. The truth is that drinking heavily is a hazard, and for most women, it’s one worth avoiding. “It won’t happen in one week, one month, one year, or maybe even in 10 years,” says Zakhari, “but eventually risky drinking will catch up with you.”

The best way to protect yourself while still enjoying a tipple or two is to get real about how much you’re sucking down. Start by keeping a paper or digital drink diary (via apps such as DrinkTracker), much as you might record what kinds of foods you nosh. And be totally honest–many women are clueless or lie to themselves and their physicians about how much they really consume. “We advise doctors to at least double whatever people tell them about their drinking habits,” says Anne Felton, R.N., of the University of Colorado Hospital’s Center for Dependency, Addiction, and Rehabilitation. (As Haley’s case proves, Felton is likely right.)

If your notes reveal you regularly go over the limit, it’s time for even more awareness, says Nowinski. He suggests asking yourself questions like “Do you automatically uncork a wine bottle when you get home, eager to unwind?” and “Do you drink socially because you’re just in ‘me too’ mode when ordering?” Whatever your answers, the key is finding out how all those drinks end up in your hand–and being aware of how much alcohol you actually imbibe. (Looking for an alcohol-free way to unwind? Try this Stress-Conquering Yoga Routine.)

The next step, cutting down on drinking, doesn’t have to be a total buzzkill. You can still go out with pals and fit in at work, just in healthier ways. First, try swapping some of your alcohol-based activities for healthier ones–the Saturday-night girls’ get-together for a Sunday-morning spa outing, for instance. When you can’t avoid cocktails, particularly in work-related scenarios, Felton suggests ordering a club soda with lime instead of that second vodka and soda; people are less likely to put you on the spot if they can’t spot the difference. At dinners, try waiting until your food arrives before ordering a glass of wine. That way you won’t drink before and during your meal, says Felton. At bars, order a water with your cocktail and alternate sips, which will force you to drink slowly but still allow you to always hold a glass.

Regardless of where or when you partake, make sure you don’t do it on an empty stomach–food helps delay the absorption of alcohol, giving your liver, heart, brain, and other critical body parts a much-needed break. Because while booze-soaked nights out can offer lots of fleeting fun, you need your organs in top shape for a long, long time.